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What Causes Cold, Fever And Severe Night Sweating In A Teenager?

Posted on Wed, 2 Mar 2016

Question: I need a quick advice about my 12 years old. He seems to have cold with heavy cough- strong but not when he sleeps. He had fever tonight 101.5 and he received fever medication and later cough medicine. By the time to go to bed his fever was down to 98.6 but 3 hours after he had been sweating a lot so all his bed was wet. His temperature is currently 95.3 underarm. Is this dangerous and what should I do.. let him keep sleeping or keep him up?

Answered by Dr. Sumanth Amperayani (12 minutes later)

Brief Answer:
Let him sleep - Do not disturb him.

Detailed Answer:
Hi...let him sleep and do not disturb him. This is a normal response for the kid with viral illness when the fever breaks.

I will tell you how a viral illness behaves so that you can be more confident.

Fever of few days without any localizing signs could as well a viral illness. Usually rather than fever, what is more important is the activity of the child, in between 2 fever episodes on the same day. If the kid is active and playing around when there is no fever, it is probably viral illness and it doesn't require antibiotics at all. Once viral fever comes it will there for 4-7 days. So do not worry about duration if the kid is active.
Paracetamol can be given in the dose of 15mg/kg/dose (maximum ceiling dose of 500mg) every 4-6th hourly that too only if fever is more than 100F. I suggest not using combination medicines for fever, especially with Paracetamol.

Regards - Dr. Sumanth

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sumanth Amperayani (7 minutes later)

Thank you. Today was his first day of fever and he was sleepy and tired all day, not his usual himself.
He was coughing bad about month ago with no fever and it lasted 2 weeks. Now he is coughing bad again. The coughing is not all the time but in spouts. Throat hurts mildly.
He is 12 and has weight of 135 so he pretty much can get adult dose of medicine. I am just very worried about 95.3 (35.1C)degree temperature as it is very low. Can it be because of heavy sweating? I never seen anybody with fever being soaking wet like he was.
His temperature normally has been little lower tnah normal as well but never so low. I am just very worried mom. Do you think it can be sepsis?

Answered by Dr. Sumanth Amperayani (1 hour later)

Brief Answer:
Drenching sweats can sometimes lower body temperature

Detailed Answer:
Hi.... drenching sweats can sometimes cause such low body temperature. I will tell you the signs of sepsis so that you can be more confident about the issue.

The kid would have been listless or extremely tired with lot of malaise and with decreased urine output or fast breathing or respiratory distress or extremely shallow breathing and mottled skin appearance if it had been sepsis.

If the kid is otherwise normal when awake with normal urine output you need not worry.

If you are willing to check - I suggest you just put three fingers at the wrist on the palmar aspect so that you can feel is pulse.... if you can feel it normally, low body temperature is unlikely to be due to sepsis.

Regards - Dr. Sumanth

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sumanth Amperayani (20 hours later)

H again and thank you for previous replys. I took him to urgent care today because of his constant cough. His pulse oxygen was little low 92 and later 95 and pulse around 101-104. They did chest xray but it was inconclusive. Radiologist said it is clear but doctor said he does see some congestion there. He said it is probably not pneumonia but still prescribed antibiotics that he needs to take 2 times first day and then 1 time 4 days. After taking first dose, he felt sick and had pain in cheek and lips, so I am not sure if I should give it to him anymore. Also should he really be taking it if xray did not show clear findings. What to think about his oxygen? ( taken from clip on finger). His fever still got up this evening aroun 101 but came down without medication and again he was sweating a lot.

Answered by Dr. Sumanth Amperayani (23 minutes later)

Brief Answer:
Low oxygen in blood could be due to a viral associated wheeze too

Detailed Answer:
Hi...Low oxygen in blood could be due to a viral associated wheeze too. It doesn't mean that it will require antibiotics.

I would like to know what antibiotic was prescribed and what is the strength and dose?

Please get back if the the cheek and lip pain occurred immediately after taking the drug/ Antibiotic.

Regards - Dr. Sumanth

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Sumanth Amperayani (54 minutes later)

antibiotics is Azithromycin 500 mg first day and 250 mg 4 days. Doctor listened his chest but did not hear wheezing, xray was done just in case and the doc and radiologist did not agree on what was in it.. one saying its is clear, one saying there is something... He still feels quite bad, fever and cough that hurts his stomach when he is coughing. he says pain is in straight line. It does not hurt when he does not cough

Answered by Dr. Sumanth Amperayani (4 hours later)

Brief Answer:
Pain during coughing is a sign of bronchitis - either viral or bacterial

Detailed Answer:
Hi....Pain during coughing is a sign of bronchitis - either viral or bacterial. But at the same time, when he has developed this cheek and lip pain cannot be ignored.

These are my suggestions for you -

1. Do not give further doses of azithromycin as the kid seems to be allergic for it.

2. Can you please upload the image of the X-ray after putting it in the X-ray lobby. You need to take the photo shot without the flash on. I know this is too much to ask for, but I genuinely want to give you my accurate professional opinion and that why I am suggesting this.

3. I suggest using a good cough suppressant like Promethazine available as Phenergan along with anti-wheezing medication like Levosalbutamol or Salbutamol to counter the cough. These are prescription drugs and you will need a prescription for it. I am suggesting anti-wheezing medication because he had low oxygen in the blood and there is an entity called Cough variant asthma, where cough will be the only symptom related to lungs even though there is bronchoconstriction and wheezing.

4. After seeing the X-ray I would suggest you if antibiotics are really required or not.

Regards - Dr. Sumanth

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Above answer was peer-reviewed by : Dr. Vaishalee Punj